Richard C. Nap, DVM, PhD, DECVS, DECVCN
What does your staff answer when they are asked: "Why does the clinic open the doors on Monday?" Their answers to this simple question hold the clue to an important management principle.
When veterinarians, veterinary students and staff are being asked this question, the majority answers in terms of "we open to treat patients, take care of sick animals and prevent disease." When aided with the choice between 2 options (1 - to support animal healthcare; and 2 - to make a profit), about 2/3 of the respondents will chose option 1, i.e., the support of animal healthcare option. However, after explanation and discussion, all of them understand that option 1 cannot be achieved without delivering option 2. The clinic needs to be profitable in order to deliver on the promise of optimal healthcare.
In the ideal case, the answers by the staff members to the "Why do we open the doors on Monday" question are consistent and are in line with the vision of the clinic owner(s). How do you get to the point that all the employees are clear on the reasons why the doors are opened on Monday? It is obvious that this is not the result of some coincidence or a random process but in contrast that it will be the result of a well-planned and executed strategic process that starts at the top with the owner(s) having a clear vision for their business. What does (s)he want her business to represent today and in 5 and 10 years from now? Here we link to the brand identity. What does her/his brand represent and how does (s)he communicate that to the target audiences, including clients and providers? Choices to be made at the start of the process can affect all aspects of the business including the decision on target animal species (horses, farm animals, exotics, birds, fish, dogs and/or cats, and within these sub-selections such as breeds) to be treated as well as the quality levels. Which is the level of positioning of the business in the quality-price pyramid?
Strategic planning is an annual process and starts with the owner(s) writing down (or reconsidering/rewriting) the vision and mission statements for the business (clinic) in as few as possible words with every word being essential to the meaning of the statement. These two statements hold the answers to the questions: 1. Where do we want to go? (vision) and 2. How do we get there? (mission). Although these terms are sometimes confused, this should not distract from their meaning. From the mission statement one can deduce strategies (statements that start with "the need to ...") and objectives. Plans should include a short-term (1 year), midterm (3 years) and long-term (5 to 10 years) plan. Each year each of these can be revised and adapted as a result of evaluation of changes within the company or within the environment (economy and competition).
Although the owner is by definition responsible for the first step of the process and it typically goes top-down, the final outcome should be the result of in-depth discussions within the company and within teams. By involving all members of the teams, they first of all get a full understanding of the meaning and importance of the process and secondly get a sense of ownership for the outcome of the process. The times that owners could just order employees to do something are over and have been proven time and again to be obsolete, leading to inferior results compared to a management that involves all team members.
During the strategic planning process from the overall business strategies and objectives the strategies and objectives for business units and departments will be deduced as a logical breakdown to reach the overall plan. This will put the responsibility for the success (and failure) of part of the overall plan with a specific group of people within the organization. Depending on the size of the business, the next step is to break it down even further and decide on smaller business units and eventually on individual objectives and responsibilities for each team member. These responsibilities and targets are agreed upon between the manager and the employee and documented in the job description and standards of performance (SoP). Each employee should have at least 2 scheduled meetings per year with her or his manager to evaluate "how we are doing against the plan." The midyear evaluation offers opportunities for adaptations if needed, and the year-end meeting will be the basis for the annual evaluation of the employee performance. In case of doubts or concerns (on the side of the employee or on the manager side), more frequent meetings need to be scheduled.
When the overall business process is organized in this way, each employee understands how her/his responsibility is part of the overall business plan and how her/his success and failure influences overall team and business performance. They will also have some insights in top-level financial objectives as these are part of the overall planning. Not all employees need to have full financial disclosure of the business financial status, but each should have some understanding of the global picture. Understanding of the relative portion of the fixed and variable costs and the costs of the training of staff and of investments needed to keep the business running at the level in line with the objectives, will help staff members understand that each individual within the organization needs to care and contribute to the financial results in order to 1) guarantee the (high) level of services they have agreed to deliver by committing to the clinic vision and mission; 2) pay the monthly fixed costs; 3) perform maintenance for buildings and equipment; 4) allow for innovations to be implemented; 5) deliver a fair return on investment for the owners, and, last but not least, to 6) pay the salaries, the trainings and leave of absence (medical, maternity, etc.) programs for each of the staff members.
1. Moreau PH, Nap RC. Essentials of Veterinary Practice. An Introduction to the Science of Practice Management. Hereford, UK: Henston Publishing; 2010.